REVIEW OF LITERATURE. Introduction The review of literature for this grant proposal will discuss the current issues as it relates to access to care in Georgia, negative health outcomes that both rural residents and Black mothers experience, similar programs that have been implemented in the US and internationally and how the current global pandemic has impacted this ongoing issue. There are many different forms of literature used for this review of literature. Peer-reviewed journal articles were used because of their validity when it comes to topics addressed. Other non-traditional forms of literature such as new reports, information from consultant groups and government agencies were used to further justify information found from peer-reviewed articles. Some of the topics have not been heavily researched for publication in peer-reviewed articles, so non-traditional forms of literature provide information on certain topics. Literature Review Access to care in rural Georgia counties continues to be an ongoing issue. The Georgia Board of Health Care Workforce (2017) released a report that included the current number of physicians in Georgia counties. The report also includes the counties that do not have practicing physicians based on specialties. Eight of the 159 counties do not have a practicing physician; all of which are rural counties. This same report found that 75 counties do not have a practicing Obstetrics and Gynecologist (OB-GYN). Many counties overlap with not having a family medicine doctor or an OB-GYN including Xxxxxxxxxx, Gaslcock, Truetlen, Talbot, Webster, Quitman, Clay, Atkinson, Echols, Xxxxxx and Xxxxxx. This lack of physicians, in part, is due to the closing of hospitals in these areas. In the past 10 years, Georgia has had 7 hospital closures in rural counties, with 18 more being deemed “vulnerable” for closure (The Chartis Group, 2020). With the closing of hospitals, these rural areas lose physicians, including OB-GYNs.
Figure 1 GA Board of Health Care Workforce, 2017
REVIEW OF LITERATURE. 9 METHODS 16 RESULTS 31 DISCUSSION 59 REFERENCES 69 APPENDICES 73 INTRODUCTION
Figure 1. Visual of the process of the formative research using a barrier analysis and theoretical application to create an SBCC to ultimately contribute to the MoreMilkiT project.
1. Mother consumes one extra meal during pregnancy
2. Mother consumes one extra cup of milk during pregnancy
3. Mother consumes at least five food groups per day during pregnancy (diverse diet)
4. Mother exclusively breastfeeds the child for the first six months 5. Mother consumes one extra meal while breastfeeding
6. Mother consumes one extra cup of milk while breastfeeding
7. Mother consumes at least five food groups each day while breastfeeding (diverse diet) 8. Infants 6-12 months consume three meals per day
9. Infants 6-12 months consume at least four food groups per day (diverse diet)
10. Animal milk is boiled each time before feeding to child
11. Children 12-24 months consume four meals per day
12. Child 12-24 months consume at least four food groups per day (diverse diet)
13. Child 12-24 months consumes one extra cup of milk each day
14. Mother continues to breastfeed until child is at least 24 months Diet practices and consumption patterns during these four stages are important in similar yet independent ways. The nutritional and health implications of this will be discussed further in the review of literature. Concurrently, it is important to establish a theoretical base that the behaviors can be matched with to form the intervention functions. The Theoretical Domains Framework (TDF) was created by a set of behavior experts that sorted an original 112 theoretical constructs into 12 behavioral domains.11 This set of domains was tested using several validation methods, and created to address a wide array of potential barriers to behavior.27 The 12 domains were then mapped onto the COM-B model. The COM-B model illustrates how capabilities and opportunities affect motivations which ultimately affect behavior, as shown in Figure 2. Capabilities are made up of psychological and physical, opportunities consist of social and physical, and motivation is comprised of reflective and automatic.10 Figure 3 shows the association between COM-B and TDF.
Figure 2. The COM-B model.i Adapted from: Xxxxxx S, Xxxxxx L, and West R 2011.10 Figure 3. Theoretical Domains Framework mapped onto the COM-B model. Adapted from Cane J, X’Xxxxxx D, Xxxxxx S 2012.11
REVIEW OF LITERATURE. A review of the available and/or published pertinent geologic and geotechnical literature concerning the project site and surrounding area.
REVIEW OF LITERATURE. A study by Xxxxxxxxxx et al8 on a computer assisted digital videokeratoscopy to map the corneas of 28 family members of 5 patients with Keratoconus. Abnormalities observed in those family members included central steepening, greater steepening of the cornea inferior to the apex, and substantial asymmetry in the central dioptric power between the two eyes of the same individual. These findings may represent the variable expression of a gene contributing to the development of Keratoconus. Pedigree analysis in these families suggests an autosomal dominant inheritance. elevation based topographers and OCT can help us to visualize the posterior surface of cornea and can also give an accurate idea about the pachymetry of entire cornea also these newer modalities can help us to diagnose Keratoconus in preclinical stage, thus allowing an early treatment. S) value, relative skewing of the steepest radial axes (SRAX), and keratometric astigmatism (AST) indices in 25 patients with bilateral Keratoconus. Then he found that KISA% was significantly more sensitive and specific than the other indices examined. And Furthermore, he found that it was significantly better at predicting positive and negative results than the other indices included in the study. 2.94, and 5.71 (all P<.001 after adjusting for covariates). Over a median follow-up of 4.1 years, approximately 28% in the Keratoconus-suspect group progressed to early Keratoconus or Keratoconus and 75% in the early Keratoconus group progressed to Keratoconus. Using all 3 indices and age, 86.9% in the normal group, 75.3% in the early Keratoconus group, and 44.6% in the Keratoconus- suspect group could be classified, yielding a total classification rate of 68.9%. corneal power, anterior curvature, posterior curvature, pachymetry, and corneal aberration data generated from the dual Scheimpflug analyzer showed promising results in differentiating Keratoconus and early Keratoconus eyes from normal eyes. Keratoconus patients, with 10 of 195 (5%) normal identified as Keratoconus. And also by adding the SRAX (steepest radial axes) index of greater than 21° to these indices, 39 of 40 (98%) Keratoconus patients were identified, but only 1 of 195 (0.5%) normal was identified as Keratoconus. Finally he concluded that the new index which quantifies irregular astigmatism in Keratoconus increases the specificity of previously reported quantitative descriptors of Keratoconus without decreasing their sensitivity. Beutel15 compared the...
REVIEW OF LITERATURE. Asthma is a chronic respiratory disease characterized by narrowing, swelling, and congestion of the airways in the lungs. When these airways react because of asthma, the muscles around them tighten, causing less air to flow into the lungs. Swelling and mucus-producing cells further narrow the airways. Combined, these factors make it difficult to breathe (Asthma and Allergy Foundation of America, 2016). Symptoms of asthma include coughing, wheezing, shortness of breath, increased production of mucus, and chest tightening. The frequency of asthma symptoms varies among individuals and can manifest as infrequent mild symptoms that require rest and medication, to status asthmaticus, a severe asthma episode and medical emergency (Asthma and Allergy Foundation of America, 2016). In most children, asthma develops before the age of 5, and, in more than half of asthma diagnoses, symptoms develop before the age of three. Before puberty, the prevalence of asthma is 3 times higher in boys than in girls. During adolescence, the prevalence is equal among males and females (Asthma and Allergy Foundation of America, 2016). Factors that may put children at an increased risk of developing asthma and an increased incidence of asthma exacerbation include: premature birth; wheezing with respiratory syncytial virus (RSV) or rhinovirus; increased exposure to indoor and outdoor pollution; exposure to tobacco smoke during pregnancy and throughout childhood; a family history of asthma; and a personal history of allergies or eczema (Asthma and Allergy Foundation of America, 2016). In addition, high levels of stress and negative life events in children increase the risk of asthma exacerbations in the subsequent weeks following the initial stressor (Asthma and Allergy Foundation of America, 2016). Many children with asthma appear and sound normal so further diagnostic tests are used to make a diagnosis. Spirometry testing measures the flow and volume of air blown out after a child takes a very deep breath and then forcefully exhales. Additional testing may be recommended to ensure that another condition is not the cause of a child's coughing or wheezing (Asthma and Allergy Foundation of America, 2016). This may include a chest x-ray, sweat chloride test (for cystic fibrosis), barium swallow (for gastroesophageal reflux or GERD), modified barium swallow (for aspiration), or skin or blood testing (for allergies or immune system disorders). Population-based asthma severity prevalence esti...
REVIEW OF LITERATURE. Changes in the alveolar bone dimensions invariably occurs after tooth extraction. During socket healing period, new bone grows into the extraction site while the alveolar ridge is being resorbed. Several studies have demonstrated that the height and width of the alveolar bone has been reduced significantly and immediately after tooth extraction.[5,6,7] Xxxxx et al (1960)[5] in his study, explained the events following extraction When a tooth is removed, there is haemorrhage followed by formation of a blood clot that fills the entire socket. This is an inflammatory reaction that stimulates recruitment of cells to form granulation tissue. Within 48 to 72 hours after extraction the clot starts to breakdown as granulation tissue begins to infiltrate the clot especially at the base of the socket. By four days the epithelium proliferates along the socket periphery and immature connective tissue is apparent. After seven days the granulation tissue has completely infiltrated and replaced the clot. At this stage, osteoid is evident at the base of the socket as uncalcified bone spicules. Over the next 2–3 weeks this begins to mineralize from the base of the socket coronally. This is accompanied by continued re- epithelialization which completely covers the socket by six weeks post-extraction. Further infill of bone takes place with maximum radiographic density at around 100 days. Studies by Xxxxxxxxxx et al (1967)[6] showed that maximum changes in alveolar dimension takes place within 12 months immediately after extraction. Dimensional loss of socket bone hinders dental implant placement and conventional prosthesis. Therefore, in order to maintain the alveolar ridge dimensions, it is essential to perform socket preservation procedures after tooth extraction, which can be done by placing grafting materials in the extraction socket as a framework for bone deposition. Xxxxxxx et al (2003)[7] in his study, showed Healing of an extraction socket is characterized by internal changes that leads to formation of bone within the socket, and external changes that leads to loss of alveolar ridge width and height. Xxxxxxx et al (2003)[8] studied the effect of a single tooth extraction of premolar or molar teeth on bone healing and soft tissue changes using clinical and radiographic measurements as well as digital subtraction radiography. They showed that the major changes take place in the 12 months following an extraction with an average of 50 per cent reduction in the width of...
REVIEW OF LITERATURE. College and career preparation—a mandate connected to the Common Core movement— is forcing educators across the nation to ensure students have the skills to compete in the 21st century. The skills needed for today’s workforce go beyond the traditional education that’s been expected in our schools for the last hundred years. Now all (not some) of our students must be prepared for post-high school training and lifelong learning. Gone are the days in which students with low skills to learn and adapt to the workplace can find a viable career to sustain themselves and their families. Xxxxxxx-Xxxxxxx (2010) states, Students need to design, evaluate, and manage one’s [their] own work so that it continually improves, frame, investigate, and solve problems using a wide range of tools and resources, collaborate strategically with others, communicate effectively in many forms, find, analyze, and use information for many purposes, and develop new products and ideas. (p. 4) These skills and concepts are making educators rethink how they guide or improve instruction to ensure student learning. Educators will have to realize the economic effects on our national, state, and local economies if students are not properly prepared for college and career. The US is facing ongoing challenges to meet the workforce needs of an economy that is STEM-based. The US continues to fall behind other industrialized nations in this expanding area, causing enormous economic and workforce gaps. US industries have turned to recruiting and importing workers from around the world to fill STEM jobs that American students are unqualified for. As the US continues to move out of the Great Recession, the economic impact of the changing job market continues to leave a tremendous impact on citizens who are or are not college- and career-ready. Xxxxxxxxx, Xxxxxxxxxxx, and Xxxxxx (2016) highlight the effects of an evolving economy in which jobs are (now more than ever) requiring workers to have some post- high school training (i.e. college). Xxxxxxxxx, Xxxxxxxxxxx, and Xxxxxx (2016) also identified how the US economy is producing jobs; however, the jobs being produced are not targeted toward workers who do not hold a college degree or have college skills. According to Xxxxxxxxx, Xxxxxxxxxxx, and Xxxxxx (2016), “the economy has added 11.6 million jobs since the recession bottomed out – 11.5 million, or 99 percent of them have gone to workers with at least some college education,” (p. 1). However, “of the...
REVIEW OF LITERATURE. Complex humanitarian emergency Rotavirus and rotavirus vaccine Mortality, morbidity, and burden of rotavirus disease – developing countries
REVIEW OF LITERATURE. HIV HIV in the South
REVIEW OF LITERATURE. In Indonesia, this lease-purchase agreement has not been regulated in a separate law, so that in practice problems often arise related to the lease-purchase institution. Under these circumstances, the leasing agency is deemed to be lacking in providing legal certainty. Therefore, it is necessary to hold a law that regulates leasing. Motorcycles are one of the most vital transportation needs, because having and using a motorbike is considered to be able to support all human activities themselves. For example, when going to work, school, visiting relatives' places, or even as a means of carrying out their work such as salespeople who have to get around from one place to another by motorbike. The economic condition of the population is a condition that describes human life that has economic score (Xxxx et al, 2020). Realizing the economic limitations of the people of Surabaya, one of the dealers in the city of Surabaya, namely the Panorama Motor Dealer, provides convenience in getting a motorbike, buying a motorbike in installments and using a lease and purchase agreement where the agreement contains the rights and obligations of the seller and the buyer. This shows that rental and purchase institutions have a place in society, both in the upper middle class and the lower middle class. The lease-purchase agreement has a double benefit, which is to benefit both parties, both the seller and the buyer. For motorcycle sellers profit because more vehicles will be sold. While the advantage for buyers is that buyers will soon be able to obtain goods (motorcycles) even though they do not have sufficient cash in cash (Xxxxxxxxxxx, 1994).
